Clinical and pathologic study of abnormal uterine bleeding in
premenopausal women to evaluate the prognostic variables of endometrial
hyperplasia
Hoon Cho (1), Ji-Kyung Ko (1), Im-Soon Lee (2), Hong-Kyoon Lee (1)
Department of Obstetrics and Gynecology, Inje University, Sanggye Paik
Hospital, Seoul, Korea (1); Department of Obstetrics and Gynecology,
Soonchunhyang University, Soonchunhyang Hospital, Seoul, Korea (2)
Objective: We performed this study to understand correlation between
clinical aspects and pathological findings of abnormal uterine bleeding (AUB)
and to evaluate the prognostic variables of endometrial hyperplasia.
Method: We reviewed 500 premenopausal women with abnormal uterine
bleeding who underwent endometrial biopsy from January 1996 to February 2003,
retrospectively. Pregnants, women who had hematologic disease, or those who used
iatrogenic hormones were excluded. The age of women with AUB was mostly in the
5th decade (41.3+6.8). Body mass index (BMI) in most of women (69.6%) was
between 18.6 and 24.9 (22.7+3.5).
Results: Among AUB menorrhagia (51.0%) was the most common bleeding
pattern, and the next one was intermenstrual bleeding (38.0%). Histologic
findings of endometrium were proliferative phase (34.0%), hyperplasia (26.4%),
and seceretory phase (22.6%), in order of frequency. 79.0% (104 cases) of
endometrial hyperplasia were simple hyperplasia, 16.0% (21 cases) were complex
hyperplasia, and 5.0% (7 cases) were atypical hyperplasia. The associated
diseases were myoma uteri, hypertension, and diabetes mellitus, in order of
frequency. The endometrial hyperplasia was diagnosed in 46.4% of patients whose
BMI was between 27.0–29.9, in 40% of patients between 30.0–34.9, and in 100%
of patients whose BMI was 35.0 or more. The endometrial hyperplasia was
diagnosed in 40.6% of patients with an endometrial thickness measured 15.1mm to
20.0mm, in 57.1% of patients with 20.1mm to 25.0mm, and in 100% of patients with
25.1mm or higher.
Conclusion: In premenopausal woman with AUB, the endometrial
hyperplasia was highly associated with women whose BMI was 27.0 or higher, or
with endometrial thickness measured more than 15.0mm. Therefore endometrial
biopsy should be taken in women with AUB whose BMI is high, or endometrial
thickness is thick to exclude the endometrial hyperplasia.
